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New aspects in diagnosis and treatment of atrial fibrillation

ESC Congress 2010

Atrial Fibrillation


New anticoagulants, new genetic diagnosis and the interaction with neurologist for a better treatment of atrial fibrillation patients.

The 2010 joint session between the ESC and the European Stroke Conference was a great success of attendance and interest.

The genetic aspects of A Fib were treated very clinically by Dr. Holm. She underlined the importance of some genes in selecting patients at higher risk of recurrences after AF ablation and the occurrence of AF in patents undergoing bypass surgery. We really need another risk factor for developing AF, independent of the usual clinical ones (ischemia, hypertension, diabetes, etc).

The great clinical interest in new anticoagulants was clear to all the attendees in the presentation of Dr. Diener. He underlined the importance of Dabigatran and of the upcoming results of other new oral anticoagulants in substituting warfarin for millions of patients with AF. Among so many important points, a wise suggestion was to use anticoagulants looking at the risk/benefit ratio: an intracranial haemorrhage is definitively a much heavier event than most small ischemic stroke and TIA.

The cathether ablation of AF is an important procedure, often curative for AF patients. Dr Arnar extensively described importance and limitations of ablation. He underlined the importance of selecting the right patient for this procedure: look always for the extent of AF symptoms and the percentage of success / complications of AF ablation.

The greatest moment of cardiologist / neurologist interaction came out of the presentation of Prof. M Hennerici, President of the European Stroke Conference. He superbly illustrated the new ASCO classification of stroke, which completely overcomes the great limitations of the previous TOAST one. He showed its importance in guiding the best therapy in stroke patients, who are very often affected simultaneously by more than one aetiological cause of stroke.

This interaction between associations will help to develop schematics for which exams are necessary and what is the best order in which to perform them in different patients, according to their pathologies: joint recommendations for cardiologists and neurologists are really needed in the light of all the news presented in this symposium.

References


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New aspects in diagnosis and treatment of atrial fibrillation
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.